Barriers and Facilitators to Point-of-Care Ultrasound Use in Rural Australia

Arnold, Annie C.; Fleet, Richard; Lim, David

doi:10.3390/ijerph20105821

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…Potential reluctance to learn and experiment with wearable US devices may impair the widespread clinical adoption of wearable US. Perceptions of setup time and device complexity by clinicians or patients may delay the adoption, as would anything requiring interpretation of US images, issues already known to be barriers in adoption of POCUS [74]. Long-term use of wearable US will raise concerns for skin damage, particularly in the elderly population, and early studies must investigate the correlation between wear time and skin health [75].…”

Section: F Potential Barriers To Clinical Adoptionmentioning

confidence: 99%

Clinical, Safety, and Engineering Perspectives on Wearable Ultrasound Technology: A Review

Song,

Andre,

Chitnis

et al. 2024

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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Wearable ultrasound has the potential to become a disruptive technology enabling new applications not only in traditional clinical settings, but also in settings where ultrasound is not currently used. Understanding the basic engineering principles and limitations of wearable ultrasound is critical for clinicians, scientists, and engineers to advance potential applications and translate the technology from bench to bedside. Wearable ultrasound devices, especially monitoring devices, have the potential to apply acoustic energy to the body for far longer durations than conventional diagnostic ultrasound systems. Thus, bioeffects associated with prolonged acoustic exposure as well as skin health need to be carefully considered for wearable ultrasound devices. This paper reviews emerging clinical applications, safety considerations, and future engineering and clinical research directions for wearable ultrasound technology.

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Section: F Potential Barriers To Clinical Adoptionmentioning

confidence: 99%

Clinical, Safety, and Engineering Perspectives on Wearable Ultrasound Technology: A Review

Song,

Andre,

Chitnis

et al. 2024

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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“…Despite its potential advantages, widespread adoption of POCUS use has been slow, with reports suggesting that only about 10% of general physicians use POCUS [ 4 ]. Several studies have revealed important barriers to POCUS use [ 3 , 5 – 9 ]. Currently, lack of training in POCUS has been reported as a top barrier to POCUS by several specialties, including lack of trained faculty to teach medical students and residents [ 5 , 9 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Facilitators, barriers, and changes in POCUS use: longitudinal follow-up after participation in a national point-of-care ultrasound training course in Japan

Yamada,

Soni,

Minami

et al. 2024

Ultrasound J

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Background POCUS training courses are effective at improving knowledge and skills, but few studies have followed learners longitudinally post-course to understand facilitators, barriers, and changes in POCUS use in clinical practice. We conducted a prospective observational study of physicians who attended 11 standardized POCUS training courses between 2017 and 2019 in Japan. Physicians who attended a standardized POCUS course were surveyed about their current frequency of POCUS use of the heart, lung, abdomen, and lower extremity veins, and perceived barriers and facilitators to POCUS use in clinical practice. Results Data were analyzed from 112 completed surveys (response rate = 20%). A majority of responding physicians were faculty (77%) in internal medicine (69%) affiliated with community hospitals (55%). The mean delay between course attendance and survey response was 50.3 months. A significant increase in POCUS use from < 1 to ≥ 1 time per week was seen for all organ systems after 50 months post-course (p < 0.01). Approximately half of course participants reported an increase in the frequency of cardiac (61%), lung (53%), vascular (44%), and abdominal (50%) ultrasound use. General facilitators of POCUS use were easy access to ultrasound machines (63%), having a colleague with whom to learn POCUS (47%), and adequate departmental support (46%). General barriers included lack of opportunities for POCUS training (47%), poor access to ultrasound machines (38%), and limited time for POCUS training (33%). In the group with increased POCUS usage, specific facilitators reported were enhanced POCUS knowledge, improved image acquisition skills, and greater self-confidence in performing POCUS. Conversely, the group without increased POCUS usage reported lack of supervising physicians, low confidence, and insufficient training opportunities as specific barriers. Conclusions Approximately half of physicians reported an increase in cardiac, lung, vascular, and abdominal POCUS use > 4 years after attending a POCUS training course. In addition to improving access to ultrasound machines and training opportunities, a supportive local clinical environment, including colleagues to share experiences in learning POCUS and local experts to supervise scanning, is important to foster ongoing POCUS practice and implementation into clinical practice.

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Antenatal ultrasound needs-analysis survey of Australian rural/remote healthcare clinicians: recommendations for improved service quality and access

Bidner,

Bezak,

Parange

2023

BMC Public Health

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Background Ultrasound is the primary diagnostic tool in pregnancy, capable of identifying high-risk pregnancies and life-threatening conditions, allowing for appropriate management to prevent maternal and fetal morbidity and mortality. Women and babies from rural and remote Australia and low-resource areas worldwide experience poorer health outcomes and barriers to accessing antenatal care and imaging services. Healthcare clinicians working in these regions face significant challenges practising with limited resources and accessing training opportunities. Objective To perform an exploratory needs-analysis survey investigating the availability, accessibility and use of antenatal ultrasound in rural Australia, exploring rural clinicians’ interest in and access to ultrasound training opportunities. Methods The survey tool for this cross-sectional study was designed and distributed as an anonymous online questionnaire targeting healthcare clinicians (doctors, nurses, midwives, clinic managers, Aboriginal healthcare workers) providing antenatal care in rural regions. Descriptive analysis was applied to quantitative data and thematic analysis was used to explore qualitative components. Results A total of 114 valid survey responses were analysed. Overall, 39% (43/111) reported ultrasound was not used when providing antenatal care to patients at their clinic, stating ‘Lack of ultrasound equipment (73%,29/40) and inaccessibility of training opportunities (47%,19/40) as the main reasons. For those with ultrasound (61%,68/111), estimating due date (89%,57/64) was the main use, and limited training/skills to operate the equipment (59%,38/64) and inaccessibility/distance of training opportunities (45%,29/64) were the most commonly reported barriers. Clinicians described a lack of childcare options (73%,74/102), long distances to reach ultrasound services (64%,65/102), appointment (59%,60/102) and transport availability/times (46%,47/102) as the main obstacles to patient access. Increased attendance, compliance with care directives, parental bonding and improved lifestyle choices were described by respondents as positive outcomes of antenatal ultrasound use. Conclusions Future efforts to combat inequitable service access must adopt a coordinated approach to meet the needs of pregnant women in low-resource settings. Providing portable ultrasound equipment, training in antenatal Point-of-Care ultrasound (PoCUS) with ongoing support/mentoring and accreditation of health professionals could strengthen rural workforce capacity. This, along with addressing the complex economic, environmental and socio-cultural barriers faced by patients, could improve service access and pregnancy outcomes in rural and remote communities.

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Barriers and Facilitators to Point-of-Care Ultrasound Use in Rural Australia

Cited by 3 publications

References 19 publications

Clinical, Safety, and Engineering Perspectives on Wearable Ultrasound Technology: A Review

Clinical, Safety, and Engineering Perspectives on Wearable Ultrasound Technology: A Review

Facilitators, barriers, and changes in POCUS use: longitudinal follow-up after participation in a national point-of-care ultrasound training course in Japan

Antenatal ultrasound needs-analysis survey of Australian rural/remote healthcare clinicians: recommendations for improved service quality and access

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